Bone Marrow Biopsy

A bone marrow biopsy takes a small sample of soft tissue from inside your bones. Your bone marrow produces blood cells and platelets. Your healthcare provider may perform this procedure if blood tests show issues with your blood cells and platelets. They may also do a bone marrow aspiration to remove fluid from your bone marrow. A specialist examines the samples.

Why would I have a bone marrow biopsy?

A bone marrow biopsy provides valuable information that your healthcare provider can use to:

• Evaluate or diagnose a condition: Your provider might order a bone marrow biopsy if they notice an abnormal number of blood cells in a blood sample. A biopsy can help diagnose blood disorders, cancer, causes of unexplained fevers or infections and more.
• Stage cancer: Cancer staging measures how much cancer has progressed. A bone marrow biopsy can show if cancer has spread to your bone marrow. It can show if a tumor in your bone marrow is growing.
• Monitor treatment progress: Your provider may perform a bone marrow biopsy to see if treatment is working. For example, you may receive regular bone marrow biopsies if you receive cancer treatments. The results can show if your bone marrow produces enough healthy blood cells after treatment.

What happens before this procedure?

Your healthcare provider will ask about your health and the medications that you take. For example, if you have hemophilia, they’ll take additional steps to manage bleeding. Medications like blood thinners may cause excessive bleeding. If you take a blood thinner, your provider may tell you to stop taking it before the procedure.

They’ll explain how they insert the needles and keep you comfortable. For instance, they may give you a sedative to help you relax. They’ll also numb the area before inserting needles.

If you are going to receive a sedative, your provider may tell you to stop eating or drinking for a period of time before the test. Plus, these medications make you sleepy or drowsy, so you’ll need someone to take you home.

What should I expect during a bone marrow biopsy?

You may have a bone marrow biopsy in your healthcare provider’s office or a hospital. You’ll be awake during the biopsy, but your provider may give you medication to help you relax. Next:

1. Your care team will help you get into position on a treatment table. The back of your hip bone is the most common spot for a biopsy, so you’ll typically lie on your side with your legs pulled up toward your belly.
2. Your provider will clean your skin with an antiseptic.
3. They’ll inject numbing medication through your skin to the bone’s surface. You’ll feel a sharp pinch.
4. They’ll make a small cut (incision) to insert a special biopsy needle into your bone. The needle has a small syringe to get fluid from your bone marrow. This is a bone marrow aspiration.
5. Your provider will use a larger needle with a special shape to remove a small amount of tissue that’s shaped like a cylinder or core.
6. They’ll remove the needle and put pressure on your skin to stop any bleeding.

The test takes about 10 to 20 minutes.

Is this test painful?

You may feel a sharp sting when your provider removes fluid from your bone and a dull pain when they remove tissue. Let them know if you feel more pain than expected. They may give you different or more medication.

What are the risks and side effects?

There are very few complications and side effects. Rarely, you may have heavy bleeding at the biopsy site or develop an infection. Applying pressure usually stops unusual bleeding. Your provider will treat the infection.

What to expect after a bone marrow biopsy

If you receive sedation, you’ll rest in a recovery room for one to two hours before you go home. Your healthcare provider will explain what you should do as you recover. They may tell you to:

• Take a nonprescription pain reliever.
• Keep the injection site dry for 24 hours.
• Wait 24 hours before you exercise or do strenuous physical activity.

What type of results do you get from a bone marrow biopsy?

Your provider will explain your results and discuss next steps. Results vary based on your situation.

When should I call my doctor?

Call your healthcare provider if you experience infection symptoms, like:

• Heavy bleeding or drainage from the injection site
• Swelling
• Spreading skin discoloration
• Fever or worsening pain